Provider Demographics
NPI:1770736589
Name:LIN, TINA (L AC)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:MEI-HSIN
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:L AC
Mailing Address - Street 1:2308 WICKERSHAM LN
Mailing Address - Street 2:APT 2007
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-4773
Mailing Address - Country:US
Mailing Address - Phone:512-627-6633
Mailing Address - Fax:
Practice Address - Street 1:1707 FORTVIEW RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7620
Practice Address - Country:US
Practice Address - Phone:512-444-8091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00792171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist